Limits...
Micrometastases in sentinel nodes of gastric cancer.

Ajisaka H, Miwa K - Br. J. Cancer (2003)

Bottom Line: We succeeded in detecting SNs of clinically early gastric cancers by intraoperative injection of a blue dye around the tumour.Expressions of cytokeratin-18 (CK-18), carcinoembryonic antigen (CEA), human telomerase reverse transcriptase (hTRT) and MUC-1 in SNs were determined by RT-PCR and Southern blot assay.However, CK-18 mRNA was expressed in 15 (7.0%), CEA in 12 (5.6%), hTRT in 10 (4.7%), and MUC-1 in 12 (5.6%) nodes, with at least one mRNA marker expressed in 25 nodes (11.7%) obtained from six patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, Takara-machi 13-1, Kanazawa 920 8641, Japan.

ABSTRACT
The sentinel node (SN) is the first lymph node in the lymphatic basin to be affected by metastasis from the primary tumour and is used to predict the status of the remaining nodes in the basin. We succeeded in detecting SNs of clinically early gastric cancers by intraoperative injection of a blue dye around the tumour. In the study presented here, multiple-marker reverse transcription-polymerase chain reaction (RT-PCR) was used to detect micrometastases in SNs and results were compared with those obtained with conventional histology. Expressions of cytokeratin-18 (CK-18), carcinoembryonic antigen (CEA), human telomerase reverse transcriptase (hTRT) and MUC-1 in SNs were determined by RT-PCR and Southern blot assay. Of the 213 SNs obtained from 35 cases of gastric cancer, eight nodes (3.8%) from five patients contained metastases that could be identified by conventional histology. However, CK-18 mRNA was expressed in 15 (7.0%), CEA in 12 (5.6%), hTRT in 10 (4.7%), and MUC-1 in 12 (5.6%) nodes, with at least one mRNA marker expressed in 25 nodes (11.7%) obtained from six patients. In the five patients with nodal metastases identified by conventional histology, two had metastases in both SNs and non-SNs. And, in the 30 patients without nodal metastases identified by conventional histology, one patient with micrometastases in the SNs identified by RT - PCR and Southern blot assay also had metastases in non-SNs as identified by serial sectioning and immunostaining of CK-18. All additional metastases were detected in non-SNs located in the same lymphatic basin as the previously detected SNs. This suggests that lymph node dissection of early-stage gastric cancer in the lymphatic basin may be mandatory even for patients without histologically detectable metastases in SNs.

Show MeSH

Related in: MedlinePlus

Sensitivities of RT–PCR and Southern blot assay of mRNA markers for gastric cancer. In 106 lymphocytes, one cell of the MKN-45 gastric cancer cell line could be detected by CK-18 and CEA, 10 cells could be detected by hTRT, and 100 cells could be detected by MUC-1.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2376932&req=5

fig1: Sensitivities of RT–PCR and Southern blot assay of mRNA markers for gastric cancer. In 106 lymphocytes, one cell of the MKN-45 gastric cancer cell line could be detected by CK-18 and CEA, 10 cells could be detected by hTRT, and 100 cells could be detected by MUC-1.

Mentions: None of the four mRNA markers, CK-18, CEA, hTRT, or MUC-1, was expressed in any of the negative controls, that is lymphocytes from five healthy donors and five lymph nodes obtained from patients without cancer. CK-18 was expressed in eight (73%) of 11 lymph nodes containing gastric cancer metastasis, CEA in seven (64%), hTRT in six (55%), and MUC-1 in six (55%). In other words, at least one mRNA marker was expressed in all positive controls. CK-18 and CEA could detect 1 MKN-45 cell in 106 lymphocytes, hTRT 10 cells, and MUC-1 100 cells (Figure 1Figure 1


Micrometastases in sentinel nodes of gastric cancer.

Ajisaka H, Miwa K - Br. J. Cancer (2003)

Sensitivities of RT–PCR and Southern blot assay of mRNA markers for gastric cancer. In 106 lymphocytes, one cell of the MKN-45 gastric cancer cell line could be detected by CK-18 and CEA, 10 cells could be detected by hTRT, and 100 cells could be detected by MUC-1.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376932&req=5

fig1: Sensitivities of RT–PCR and Southern blot assay of mRNA markers for gastric cancer. In 106 lymphocytes, one cell of the MKN-45 gastric cancer cell line could be detected by CK-18 and CEA, 10 cells could be detected by hTRT, and 100 cells could be detected by MUC-1.
Mentions: None of the four mRNA markers, CK-18, CEA, hTRT, or MUC-1, was expressed in any of the negative controls, that is lymphocytes from five healthy donors and five lymph nodes obtained from patients without cancer. CK-18 was expressed in eight (73%) of 11 lymph nodes containing gastric cancer metastasis, CEA in seven (64%), hTRT in six (55%), and MUC-1 in six (55%). In other words, at least one mRNA marker was expressed in all positive controls. CK-18 and CEA could detect 1 MKN-45 cell in 106 lymphocytes, hTRT 10 cells, and MUC-1 100 cells (Figure 1Figure 1

Bottom Line: We succeeded in detecting SNs of clinically early gastric cancers by intraoperative injection of a blue dye around the tumour.Expressions of cytokeratin-18 (CK-18), carcinoembryonic antigen (CEA), human telomerase reverse transcriptase (hTRT) and MUC-1 in SNs were determined by RT-PCR and Southern blot assay.However, CK-18 mRNA was expressed in 15 (7.0%), CEA in 12 (5.6%), hTRT in 10 (4.7%), and MUC-1 in 12 (5.6%) nodes, with at least one mRNA marker expressed in 25 nodes (11.7%) obtained from six patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University, Takara-machi 13-1, Kanazawa 920 8641, Japan.

ABSTRACT
The sentinel node (SN) is the first lymph node in the lymphatic basin to be affected by metastasis from the primary tumour and is used to predict the status of the remaining nodes in the basin. We succeeded in detecting SNs of clinically early gastric cancers by intraoperative injection of a blue dye around the tumour. In the study presented here, multiple-marker reverse transcription-polymerase chain reaction (RT-PCR) was used to detect micrometastases in SNs and results were compared with those obtained with conventional histology. Expressions of cytokeratin-18 (CK-18), carcinoembryonic antigen (CEA), human telomerase reverse transcriptase (hTRT) and MUC-1 in SNs were determined by RT-PCR and Southern blot assay. Of the 213 SNs obtained from 35 cases of gastric cancer, eight nodes (3.8%) from five patients contained metastases that could be identified by conventional histology. However, CK-18 mRNA was expressed in 15 (7.0%), CEA in 12 (5.6%), hTRT in 10 (4.7%), and MUC-1 in 12 (5.6%) nodes, with at least one mRNA marker expressed in 25 nodes (11.7%) obtained from six patients. In the five patients with nodal metastases identified by conventional histology, two had metastases in both SNs and non-SNs. And, in the 30 patients without nodal metastases identified by conventional histology, one patient with micrometastases in the SNs identified by RT - PCR and Southern blot assay also had metastases in non-SNs as identified by serial sectioning and immunostaining of CK-18. All additional metastases were detected in non-SNs located in the same lymphatic basin as the previously detected SNs. This suggests that lymph node dissection of early-stage gastric cancer in the lymphatic basin may be mandatory even for patients without histologically detectable metastases in SNs.

Show MeSH
Related in: MedlinePlus